Provider Demographics
NPI:1780009555
Name:LIVING SERVICES FOUNDATION/MINNEOTA, LLC
Entity Type:Organization
Organization Name:LIVING SERVICES FOUNDATION/MINNEOTA, LLC
Other - Org Name:TOWN & COUNTRY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-231-0410
Mailing Address - Street 1:700 N MONROE ST
Mailing Address - Street 2:P.O. BOX 117
Mailing Address - City:MINNEOTA
Mailing Address - State:MN
Mailing Address - Zip Code:56264-9237
Mailing Address - Country:US
Mailing Address - Phone:507-872-5300
Mailing Address - Fax:507-872-5359
Practice Address - Street 1:700 N MADISON ST
Practice Address - Street 2:
Practice Address - City:MINNEOTA
Practice Address - State:MN
Practice Address - Zip Code:56264-9373
Practice Address - Country:US
Practice Address - Phone:507-872-5300
Practice Address - Fax:507-872-5359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN342939251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health